Determinants of length of stay in stroke patients: a geriatric rehabilitation unit experience

Abstract

The objective was to identify the predictors of length of stay--the impact of age, comorbidity, and stroke subtype- on the outcome of geriatric stroke patients. One hundred and seventy stroke patients (129 first-ever ischemic, 25 hemorrhagic, and 16 ischemic second strokes) were included in the study. The Oxfordshire Community Stroke Project classification for clinical subtypes of ischemic stroke patients and the Charlson comorbidity index were used to evaluate comorbidity. The Functional Independence Measure (FIM) scores were noted on admission and at discharge. Comparison of the patients below and over 65 years revealed that elderly patients had higher comorbidity scores, were more likely to be prematurely discharged, and were less likely to be successfully rehabilitated despite similar FIM scores on admission. Excluding premature discharges, FIM scores on admission emerged as the only predictor of length of stay. Age, stroke type, lesion characteristics, and comorbidities are not significant associates of prolonged length of stay. Results and limitations inherent to our study and similar stroke studies are discussed within the context of rehabilitation differences among rehabilitation centers and countries.

Regional Variation in Stroke Rehabilitation Outcomes

“…Demographic variables known to influence rehabilitation outcomes 46;47 were used as covariates. These factors included age, gender, race/ethnicity, marital status, and insurance status.…”

A comparison of stroke rehabilitation; data from two national cohorts

“…In the Latvian population, the duration of inpatient rehabilitation is approximately 2 weeks and is relatively fixed, whereas the median length of stay in Sweden, even when compared to other countries, is rather long (21,22). The length of rehabilitation cannot be used as a tool to describe clinical success.…”

“…According to the accepted standards of rehabilitation, the rehabilitation plan should be individualized and based on the expected improvement, which is not time limited (7). However, time is used as a tool to estimate the costs of the health care process and in some countries can be used to limit the amount of rehabilitation (22).…”

Robot-mediated upper limb physiotherapy

“…It would be advantageous to know in which phase the RMT is most useful with regard to the functional outcome. FIM in stroke rehabilitation is a useful tool, and the FIM scores on admission have been identified as being a significant predictor of length of stay of patients with stroke excluding premature discharges (Atakay and Turhan, 2009). Fasoli et al (2004b) in a trial with patients in an early stage post-stroke (inclusion three weeks poststroke on average) also found a significant improvement of FIM.…”